Healthcare Organization Survey

Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships

OMB: 0920-1129

IC ID: 220390

Information Collection (IC) Details

View Information Collection (IC)

Healthcare Organization Survey
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Healthcare Organization Survey Q7 Healthcare Organization Utilization Survey.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

234 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 234 0 0 0 0 234
Annual IC Time Burden (Hours) 117 0 0 0 0 117
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Healthcare Organization Survey - word G8 Healthcare Organization Utilization Survey.docx 03/02/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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